In older patients with chronic and degenerative diseases (multiple morbidities), geriatric syndromes, chronic and complex problems should be comprehensively evaluated. Comprehensive geriatric assessment (CGA) includes simultaneous clinical, medical, and functional evaluation of older patients. The components of CGA include physical, psychological, and socio-environmental content. Exhibiting multiple morbidities, disease severity, multidrug intake (polypharmacy), and vaccinations were evaluated from a physical perspective. Geriatric syndromes should also be evaluated. Functional evaluations included visual acuity, hearing, upper and lower extremity function, gait ability, balance, falls, urinary incontinence, weight change, oral health, nutritional status, and pain. Psychological aspects, such as depression and cognitive function status, were evaluated. The residential environment, degree of family and social support, economic status, and advanced medical directives were evaluated from a socio-environmental perspective. Older patients with functional disabilities should be screened through CGA for various problems and geriatric syndromes. However, these issues require further evaluation, treatment, and management. Thus, the health and quality of life of older adults can be maintained and improved.

In older patients with chronic and degenerative diseases (multiple morbidities), geriatric syndromes, chronic and complex problems should be comprehensively evaluated. Comprehensive geriatric assessment (CGA) includes simultaneous clinical, medical, and functional evaluation of older patients. The components of CGA include physical, psychological, and socio-environmental content. Exhibiting multiple morbidities, disease severity, multidrug intake (polypharmacy), and vaccinations were evaluated from a physical perspective. Geriatric syndromes should also be evaluated. Functional evaluations included visual acuity, hearing, upper and lower extremity function, gait ability, balance, falls, urinary incontinence, weight change, oral health, nutritional status, and pain. Psychological aspects, such as depression and cognitive function status, were evaluated. The residential environment, degree of family and social support, economic status, and advanced medical directives were evaluated from a socio-environmental perspective. Older patients with functional disabilities should be screened through CGA for various problems and geriatric syndromes. However, these issues require further evaluation, treatment, and management. Thus, the health and quality of life of older adults can be maintained and improved.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

In older patients with chronic and degenerative diseases (multiple morbidities), geriatric syndromes, chronic and complex problems should be comprehensively evaluated. Comprehensive geriatric assessment (CGA) includes simultaneous clinical, medical, and functional evaluation of older patients. The components of CGA include physical, psychological, and socio-environmental content. Exhibiting multiple morbidities, disease severity, multidrug intake (polypharmacy), and vaccinations were evaluated from a physical perspective. Geriatric syndromes should also be evaluated. Functional evaluations included visual acuity, hearing, upper and lower extremity function, gait ability, balance, falls, urinary incontinence, weight change, oral health, nutritional status, and pain. Psychological aspects, such as depression and cognitive function status, were evaluated. The residential environment, degree of family and social support, economic status, and advanced medical directives were evaluated from a socio-environmental perspective. Older patients with functional disabilities should be screened through CGA for various problems and geriatric syndromes. However, these issues require further evaluation, treatment, and management. Thus, the health and quality of life of older adults can be maintained and improved.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

In older patients with chronic and degenerative diseases (multiple morbidities), geriatric syndromes, chronic and complex problems should be comprehensively evaluated. Comprehensive geriatric assessment (CGA) includes simultaneous clinical, medical, and functional evaluation of older patients. The components of CGA include physical, psychological, and socio-environmental content. Exhibiting multiple morbidities, disease severity, multidrug intake (polypharmacy), and vaccinations were evaluated from a physical perspective. Geriatric syndromes should also be evaluated. Functional evaluations included visual acuity, hearing, upper and lower extremity function, gait ability, balance, falls, urinary incontinence, weight change, oral health, nutritional status, and pain. Psychological aspects, such as depression and cognitive function status, were evaluated. The residential environment, degree of family and social support, economic status, and advanced medical directives were evaluated from a socio-environmental perspective. Older patients with functional disabilities should be screened through CGA for various problems and geriatric syndromes. However, these issues require further evaluation, treatment, and management. Thus, the health and quality of life of older adults can be maintained and improved.

Background: Many studies have shown that Hashimoto’s thyroiditis (HT) acts as a protective factor in differentiated thyroid cancer (DTC), but little is known about its effects on mortality. Therefore, this study was performed to reveal the prognosis of HT on mortality in patients with DTC. Methods: This study included two types of research results: retrospective cohort study using the National Epidemiologic Survey of Thyroid cancer (NEST) in Korea and meta-analysis study with the NEST data and eight selected studies. Results: Of the 4,398 patients with DTC in NEST, 341 patients (7.8%) died during the median follow-up period of 15 years (interquartile range, 12.3 to 15.6). Of these, 91 deaths (2.1%) were related to DTC. HT was associated with a smaller tumor size and less aggressive DTC. In Cox regression analysis after adjusting for age and sex, patients with HT showed a significantly lower risk of all-cause death (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52 to 0.96) and DTC-related death (HR, 0.33; 95% CI, 0.14 to 0.77). The analysis with inverse probability of treatment weight data adjusted for age, sex, and year of thyroid cancer registration showed similar association. The meta-analysis showed that patients with HT showed a lower risk of all-cause mortality (risk ratio [RR], 0.24; 95% CI, 0.13 to 0.47) and thyroid cancer-related mortality (RR, 0.23; 95% CI, 0.13 to 0.40) in comparison with patients without HT. Conclusion This study showed that DTC co-presenting with HT is associated with a low risk of advanced DTC and presents a low risk for all-cause and DTC-related death.

For elderly patients with many chronic and degenerative diseases (multiple comorbidities) and geriatric syndromes, chronic and complex problems should be comprehensively evaluated. The comprehensive geriatric assessment (CGA) is an evaluation of elderly patients in which clinical, medical, and functional evaluations are performed together.Current Concepts: Components of CGA include physical, psychological, and socioenvironmental content. In the physical aspect, the presence of various diseases, determination of the severity of each disease, multi-drug intake (polypharmacy), and vaccination records are evaluated. Geriatric syndromes should also be included in the evaluation. The functional evaluation comprises visual acuity, hearing, upper and lower extremity function, gait ability, balance, fall, urinary incontinence, weight change, oral health, nutritional status, and pain. In the psychological aspect, depression and cognitive function status are evaluated. The residential environment, degree of familial and social support, economic status, and advanced medical directives are evaluated in the socioenvironmental aspect.Discussion and Conclusion: Elderly patients with functional disabilities should be screened via the CGA for various problems and geriatric syndromes that the elderly are prone to developing. Problems found require further evaluation, treatment, and management. In this way, the health and quality of life of the elderly can be maintained and improved.

Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.